1.	A cone biopsy specimen of a woman who requested that her menstrual function be preserved shows a carcinoma in situ with complete excision. She should be advised to

a.	Be discharged from follow up.
b.	Continue to attend yearly follow up for Pap smear tests.
c.	Requires hysterectomy.
d.	Requires Wertheim’s hysterectomy.
e.	Referred for prophylactic RT.

B

2.	In a pregnant lady with diabetes mellitus

a.	Insulin requirement decreases because of the fetal pancreas.
b.	Fetal mortality occurs in early pregnancy.
c.	Should be monitored by labstix.
d.	All of the above.
e.	None of the above.

E.

3.	A positive fern test of the cervical mucus in the early part of the menstrual cycle followed by a negative fern test premenstrually means

a.	Estrogen is present.
b.	Progestrogen is present.
c.	Ovulation has occurred.
d.	All of the above.
e.	None of the above.

C.

4.	Cervical carcinoma is best treated by Wertheim’s operation

a.	In the presence of 1st trimester intrauterine pregnancy.
b.	In the presence of PID.
c.	In early stage II.
d.	All of the above.
e.	None of the above.

C.

5.	Seminar fluid

a.	pH is 4.6
b.	Volume is 10ml.
c.	Contains PGE2.
d.	Produced mainly by seminiferous tubules.
e.	None of the above.

C.

6.	In NUH basic investigation for subfertile couples

a.	Analysis of seminal fluid.
b.	Hormonal analysis of the male.
c.	Post coitus test.
d.	All of the above.
e.	None of the above.

A.

7.	What is not the advantage of early booking in pregnancy?

a.	Gestational age assessment.
b.	Congenital abnormalities detected.
c.	Early abortion when pregnancy is contraindicated.
d.	IUGR in the 1st trimester detected.
e.	Pelvic pathology in pregnancy detected and treated.

D.

8.	In a gynecological examination, a per-rectal is done in:

a.	Carcinoma of the cervix.
b.	Endometriosis.
c.	Unmarried females.
d.	All of the above.
e.	None of the above.

D.

9.	Which one does not help to indicate whether the pelvis is adequate for delivery?

a.	Birth weight of last baby.
b.	Duration of previous labor.
c.	Length of last child.
d.	Method of delivery of previous labor.
e.	Indications for previous operative deliveries.

C.

10.	The clitoris doesn’t contain

a.	Erectile tissue.
b.	Corpus spongiosum.
c.	Involuntary muscles.
d.	A glans.
e.	2 crura.

B.

11.	Which of the following isn’t a reason for doing a vaginal examination in the 1st trimester of pregnancy?

a.	To exclude pelvic tumor.
b.	To assess size of uterus.
c.	To assess pelvic size.
d.	To assess fetal viability.

D

12.	Definite signs of labor

a.	Leakage of aminotic fluid.
b.	Show.
c.	Painful contractions.
d.	Painful contractions with cervical changes.
e.	Effaced cervix with 3cm dilatation.

D.

13.	When a women comes for labor

a.	Oxytocin drip is given at 1st stage labor.
b.	Oxytocin drip is given at 2nd stage labor.
c.	Oxytocin drip is given at 3rd stage labor.
d.	Drip without oxytocin given at 1st stage.
e.	None of the above.

E.

14.	In normal delivery

a.	Optimal cord cutting time is 30 – 60 seconds.
b.	Optimal residual cord length is 6 – 10cm.
c.	Should milk as much of the cord blood into the baby.
d.	All of the above.
e.	None of the above.

A

15.	Moderate uterine bleeding associated with ovulation is

a.	The constitutional variant of the individual.
b.	Usually seen in young women.
c.	Associated with a reduction in circulating estrogen levels.
d.	All of the above.
e.	None of the above.

D.

16.	What is not important in menstrual history?

a.	1st day of LMP.
b.	Duration.
c.	Pain.
d.	Color.
e.	Passage of clots.

D.

17.	Which is not found in asymmetrical growth retardation?

a.	Hypoxia.
b.	Oligohydramnios.
c.	Normal H/A ratio.
d.	Abnormal H/A ratio.

D

18.	In severe pre-eclampsia

a.	The plasma volume is reduced.
b.	The extracellular fluid is increased.
c.	There is placental insufficiency.
d.	All of the above.
e.	None of the above.

D.

19.	In polycystic ovarian syndrome, the following is not found in

a.	Wide carrying angle.
b.	Hirsuitism.
c.	Obesity.
d.	Raised LH.
e.	None of the above.

A.

20.	Amenorrhoea

a.	Is a feature of anterior pituitary destruction.
b.	May occur with continuous administration of estrogen and progesterone.
c.	May occur with anorexia nervosa.
d.	Is always present in Turner’s syndrome.
e.	All of the above.

E

21	Eclampsia management

a.	Control convulsions and hypertension and deliver immediately regardless of fetal maturity.
b.	Intubate patient to ensure airway is not obstructed and deliver by LSCS.
c.	Delivery depends on urinary output.
d.	If fetus is premature, control fits and hypertension and wait.
e.	None of the above.

A.

22.	What is the least likely presentation of twins?

a.	Cephalic-cephalic.
b.	Breech-cephalic.
c.	Transverse-transverse.
d.	Breech-breech.
e.	Cephalic-transverse.

C.

23.	Which of the following is not associated with twin pregnancy?

a.	Polyhydramnios.
b.	Anemia.
c.	Premature labor.
d.	Urinary tract infections.
e.	All are associated with twin pregnancy.

E.

24.	What (if any) are the contraindications of induction of labor?

a.	Cardiac disease in pregnancy.
b.	Breech presentation.
c.	Short stature (< 150cm).
d.	All of the above.
e.	None of the above.

B.

25.	ARM is mediated through

a.	Prostaglandin.
b.	Leukotrienes.
c.	Prostacycline.
d.	Thromboxane.
e.	None of the above.

A.

26.	Pyepagus is a state of conjoined twins whereby there is joining of the

a.	Heads.
b.	Thoraces.
c.	Abdomen.
d.	Limbs.
e.	Back and buttocks.

E

27.	Incidence of anemia is pregnancy is reduced by

a.	Spacing of children.
b.	Give iron supplements.
c.	Give oral contraceptives.
d.	Better nutrition.
e.	All of the above.

E.

28.	Maternal mortality in Singapore (1977 – 1979)

a.	2.5 per 100.
b.	7.2 per 10 000.
c.	1.4 per 100,000.
d.	10 per 100,000.

D

29.	Choriocarcinoma presentation

a.	Purplish spots in the vagina.
b.	Uterine enlargement.
c.	Irregular vaginal bleeding.
d.	Hemoptysis.
e.	All of the above.

E.

30.	Partial mole

a.	Commonly associated with CNS malformation.
b.	< 10% of pregnancy.
c.	Commonly associated with severe pre-eclampsia.
d.	All of the above.
e.	None of the above.

D

31.	Dysmaturity are infants who are

a.	Post term 42/52.
b.	Infant of diabetic mother.
c.	SGA.
d.	All of the above.
e.	None of the above.

A.

33.	Most common etiologic factor for heart disease in pregnancy

a.	Syphilis.
b.	Congenital heart disease.
c.	Rheumatic heart disease.
d.	Ischaemic heart disease.
e.	None of the above.

C

34.	What is not seen in buffy coat film in megaloblastic anaemia?

a.	Hypersegmentation of PMN.
b.	Macropolycytes.
c.	Normoblasts showing abnormal hemoglobinism.
d.	Howell Jolly bodies in RBC.
e.	All the above is seen.

D.

35.	What is not routinely done in KKH for a patient whose hemoglobin is 8.2g%?

a.	Stool for ova and cysts.
b.	PBF.
c.	Erythrocyte electrophoresis.
d.	Bone marrow film.
e.	Serum iron and TIBC.

D

36.	Normal pelvic dimensions are

a.	Anteroposterior 13cm.
b.	Transverse 11.5cm.
c.	Interspinous 10.5cm.
d.	All of the above.
e.	None of the above.

D.

37.	Physiological changes in pregnancy are

a.	Increased gastric secretion.
b.	Increased small intestine mortality.
c.	Relaxation of the gastro-esophageal sphincter.
d.	All of the above.
e.	None of the above.

C.

38.	Which is untrue?

a.	Overlapping of fetal skull before onset of labor supports the diagnosis of intrauterine death.
b.	Buddha position in X-ray suggests hydrops fetalis.
c.	Women thought to have multiple pregnancies need X-ray or ultrasound scan.
d.	Renal agenesis is associated with polyhydramnios.
e.	Fetal skeleton is visible on X-ray by 20th week.

D.

39.	The following conditions should be present before application of forceps except

a.	Must have no cephalopelvic disproportion.
b.	Head at pelvic brim.
c.	Head in occipito-anterior.
d.	Cervix fully dilated.
e.	Bladder and rectum emptied.

40.	Relevant investigations in young primigravida with severe hypertension at 34 weeks

a.	Renal creatinine clearance.
b.	PBF.
c.	Optic fundoscopy.
d.	UFEME.
e.	All of the above.

41.	A 20-year-old primigravida in established labor for 24 hours. Labor is slow, cervix remains half dilated over 6 hours, no cephalopelvic disproportion. Patient has severe sacral pain and some tenderness over lower segment. Resting tone of uterus is high. She is likely to be having

a.	Hypotonic uterine inertia.
b.	Hypertonic uterine inertia.
c.	Obstructed labor.
d.	All of the above.
e.	None of the above.

B.

42.	Following treatment should be given for the above condition

a.	Intravenous dextrose.
b.	Intravenous oxytocin.
c.	Delivery by vacuum.
d.	LSCS.
e.	Controlled anaesthesia.

D.

43.	Secondary amenorrhoea is not associated with

a.	Oral contraceptives.
b.	Sheehan’s syndrome.
c.	Genital tuberculosis.
d.	Hypothyroidism.
e.	Ginari-rommech syndrome.

E.

44.	Which of the following statements about choriocarcinoma is not true?

a.	Always preceded by mole.
b.	Urinary gonadotrophin raised.
c.	Cytotoxic drugs give increased survival.
d.	Secondary deposits in the liver.
e.	May be heralded by onset of hemoptysis.

A

45.	Which is usually not associated with failure to conceive?

a.	Cervical incompetence.
b.	Sperm count of < 5 million / ml.
c.	Tuberculosis salpingitis.
d.	Adrenogenital syndrome.
e.	Stein-Leventhal syndrome.

A.

46.	Which statement is wrong?

a.	Infertility may be associated with acute gonorrhoea.
b.	Cryptomenorrhoea may be associated with acute retention of urine.
c.	Negative pregnancy test always excludes ruptured ectopic pregnancy.
d.	Presence of chorionic villi in curetting exclude ectopic pregnancy.
e.	Sterilization by tubal ligation is regarded as irreversible.

B.

47.	Which statement about genital prolapse is wrong?

a.	Transverse ligaments take part in supporting vaginal vault.
b.	Post-natal exercises are of no value.
c.	Cervix is often elongated.
d.	Rectocoele may cause intestinal colic.
e.	Overflow incontinence is a common syndrome of urethrocoele.

B

48.	Which of the following statements about carcinoma of the cervix is untrue?

a.	Anaemia is a common terminal event.
b.	Risk of carcinoma cervix is related to parity.
c.	Post-coital bleeding is a common symptom.
d.	Histologically usually adenocarcinoma.
e.	Common site for mets are obturator nodes.

D.

49.	Which of the coupled signs and diseases are wrong?

a.	Ascites and ovarian carcinoma.
b.	Thickened uterosacral ligament and carcinoma of the corpus uteri.
c.	Discrete white patches on vagina and monilia.
d.	Enlarged inguinal nodes and Bartholin’s abscess.
e.	Thickened uterosacral ligament and endometriosis.

B.

50.	Congenital abnormalities of the uterus are associated with the following except

a.	Habitual abortion.
b.	Normal reproductive ability.
c.	Renal abnormalities.
d.	Polycystic kidneys.
e.	Cryptomenorrhoea.

D.

51.	Right ureter lies in relation to the following:

a.	Bifurcation of common iliac vessels.
b.	Infundibular pelvic ligaments.
c.	Inferior mesenteric artery.
d.	Uterine artery.
e.	Paracervical tissue. 

A

52.	Young girls may get vaginal discharge due to the following except

a.	Monilia.
b.	Ovarian dysgerminoma.
c.	Gonorrhoea.
d.	Ectopic ureters.
e.	Sarcoma.

B.

53.	50-year-old woman having irregular periods is first managed by

a.	Hormones.
b.	Oral Fe and ergometrine.
c.	D & C.
d.	Hysterectomy.
e.	Inducing menopause with radium.

C.

54.	Absolute contraindication to use of oral contraceptives

a.	Cervical erosions.
b.	Carcinoma of breast.
c.	Cholecystitis.
d.	Hyperemesis gravidarum.
e.	PTB.

B.

56.	Post menopausal bleeding is caused by the following except

a.	Cervical prolapse.
b.	Senile vaginitis.
c.	Ectopic pregnancy.
d.	Stilboesterol.
e.	Endometrial carcinoma.

C.

58.	APGAR score assess the state of the following systems in the newborn except

a.	Respiration.
b.	Locomotor.
c.	Cardiovascular system.
d.	Central nervous system.
e.	All.

E

59.	“Witches milk” results from

a.	Prolonged breast feeding.
b.	Excessive endogenous stimulation in female infants by estrogen.
c.	Increased levels of placental hormones in fetal plasma.
d.	Abnormal lactation.

60.	Respiratory quotient in a newborn is

a.	1.0.
b.	0.7.
c.	1.2.
d.	0.8.

C

61.	Meconium is composed of the following except

a.	Mucopolysaccharides.
b.	Vernix.
c.	Upper respiratory epithelium.
d.	Bilirubin.
e.	Mucoprotein.

C

62.	Labor is said to be established when contractions

a.	Are painful.
b.	Occur 1 in 30 minutes.
c.	Occur 1 in 5 minutes.
d.	There is a show and leaking liquor.

C.

63.	Tubal insufflation is contraindicated under the following conditions

a.	Just before mid-cycle.
b.	At onset of menstruation.
c.	Day after coitus.
d.	Gross chronic cervicitis. 

64.	Which of the following sperm counts are abnormal?

a.	250 million / ml.
b.	60 million / ml.
c.	20 million / ml.
d.	1 million / ml.

D

65.	Endometrial carcinoma stage 1 must be treated by

a.	Increased dosage of progesterone therapy.
b.	Cytotoxic drugs.
c.	Total hysterectomy.
d.	Cobalt therapy.
e.	Combined radiotherapy and surgery.

C.

66.	Immunotherapy must be employed in

a.	Treatment of Rh immunized pregnancy.
b.	Prevention of Rh isoimmunization.
c.	Treatment of Bart’s disease.
d.	As an adjunct to chemotherapy in choriocarcinoma.

B.

67.	The ovaries may not be conserved during hysterectomy under the following circumstances

a.	> 38 years.
b.	For pelvic endometriosis.
c.	For persistent PID.
d.	Extensive fibroids.

B.

68.	In the normal menstrual cycle, estrogen is produced from the

a.	Ovum.
b.	Ovarian stroma.
c.	Graafian follicle.
d.	Endometrium.
e.	Corpus luteum.

C.

69.	Complications of IUCD include

a.	Placenta praevia.
b.	Perforation of the uterus.
c.	PID.
d.	Chronic cervicitis.
e.	Thrombophlebitis.

B.

70.	Bleeding may be caused by vaginal examination when there is

a.	Fibroid prolapse.
b.	Cervical carcinoma.
c.	Adenomyosis.
d.	Urethral carbuncle.
e.	Ovarian carcinoma.

B.

71.	Young girls may develop vaginal discharge due to

a.	Moniliasis.
b.	Presence of foreign body.
c.	Threadworms.
d.	Ovarian dysgerminoma.
e.	Ectopic pregnancy.

D.

72.	Secondary dysmenorrhoea

a.	Means painful menstruation in those who have had at least 1 child.
b.	May precede menstrual period.
c.	Is relieved by antispasmodics.
d.	Usually associated with organic disease.
e.	Is often improved by dilatation of the cervix.

B.

73.	Heavy irregular periods in a female aged 52 may be correctly managed by

a.	Hormonal therapy.
b.	Taking a cervical smear.
c.	Inducing the menopause with radium.
d.	Administration of oral iron and ergometrine.
e.	D&C.

E.

74.	Most common cause of early abortions

a.	Physical trauma.
b.	Uterine retroversion.
c.	Abnormality of conceptus.
d.	Incompetent cervix.

C.

75.	Ovarian artery runs through

a.	Parametrium.
b.	Ovarian ligaments.
c.	Infudibulopelvic ligament.
d.	Round ligament.
e.	Urachus.

C.

76.	Turner’s syndrome is characterized by all except

a.	Webbed neck.
b.	Short stature.
c.	Primary amenorrhoea.
d.	Chromosome haplotype XO.
e.	Vaginal atresia.

E

77.	Hydatiform mole have all but the following

a.	Uterine size > period of amenorrhoea.
b.	Threatened abortion.
c.	Produce HCG.
d.	Usually have a fetus.

B

78.	Hydatiform mole have all but the following

a.	Uterine size > period of amenorrhoea.
b.	Features of missed abortion.
c.	Produce normal HCG titres.
d.	Irregular vaginal bleeding.
e.	Theca lutein cyst of ovaries.

C.

79.	Which of the following is commonly associated with cervical carcinoma?

a.	Dyspareunia.
b.	Dysmenorrhoea.
c.	Post coital bleeding.
d.	GIT symptoms.
e.	Prolapse.

C.

80.	Which of the following is not associated with failure to conceive

a.	Cervix incompetence.
b.	Sperm count of 10 million / ml.
c.	TB salpingitis.
d.	Fibroid.
e.	Bicornuate uterus.

A.

81.	Complications of abdominal hysterectomy with conservation of ovaries may be any of the following except:

a.	Apareunia.
b.	Vaginal discharge.
c.	Excessive weight gain.
d.	Hirsutism.
e.	Urinary incontinence.

D.

82.	Post-menopausal bleeding is not caused by:

a.	Cervical polyp.
b.	Ectopic pregnancy.
c.	Cervical carcinoma.
d.	Endometrium carcinoma.
e.	Senile vaginitis.

B.

83.	Cystic swelling of the anterior vaginal wall may be due to the following except:

a.	Ganter’s duct cyst.
b.	Urethrocoele.
c.	Urethral diverticulae.
d.	Ureterocoele.
e.	Cystocoele.

D.

84.	Stress incontinence is characterized by:

a.	Loss of posterior urethro-vesical angle.
b.	Recurrent urinary tract infection.
c.	Utero-vaginal prolapse.
d.	All of the above.
e.	None of the above.

A

85.	Method of preventing conception must consider:

a.	Time of ovulation.
b.	Availability of unfertilized ovum.
c.	Viability of sperm.
d.	All of the above.
e.	None of the above.

D.

86.	ECV is contraindicated when all of the following conditions are present except:

a.	APH.
b.	Hypertension.
c.	Grossly contracted pelvis.
d.	Previous LSCS scar.
e.	Polyhydramnios / oligohydramnios.

B.

87.	Recognized complications of term pregnancy include:

a.	Malpresentation.
b.	Anemia.
c.	Premature labor.
d.	Diabetes mellitus.
e.	Hydramnios.

C.

88.	In physiological anemia of pregnancy, there is:

a.	Fall in total RBC mass.
b.	Increase in blood volume.
c.	Fall in the serum iron levels.
d.	Increased plasma volume.
e.	Fall in hemoglobin volume.

D.

89.	Placental insufficiency can be suspected in all of the following except:

a.	Falling estriol level.
b.	Fetal movements are not vigorous.
c.	Amnioscopy shows clear liquor.
d.	Uterus less than dates.
e.	History of bleeding in early pregnancy.

C.

90.	Pruritus vulvae is a feature of the following except:

a.	Diabetes mellitus.
b.	Varicose veins of the vulvae.
c.	Round worm infestation of the gut.
d.	Leukoplakia vulvae.
e.	Vulval carcinoma.

C.

91.	Second stage of labor begins when:

a.	Cervix is effaced.
b.	Membranes ruptured.
c.	Caput distending the perineum.
d.	Cervix is fully dilated.
e.	Uterine cavity and vagina form a continuous cylindrical tube.

D.

92.	Management of patient in labor with fetus in transverse lie:

a.	Caesarean section if cervix is not fully dilated.
b.	Uterine version and breech extraction if cervix is half dilated.
c.	Anticipated spontaneous delivery.
d.	Rupture membrane, set oxytocin drip.
e.	Perform decapitation operation if fetus is absent.

A.

93.	Recurrent early trimester abortion due to incompetent os is best treated by:

a.	Cervical suture.
b.	Progesterone therapy.
c.	Stilbesterol.
d.	Diazepam.
e.	Isoxupurine.

A.

94.	Krukenburg tumor is ovarian tumor which:

a.	Is primary to the ovary.
b.	Secondary to any gastrointestinal tract cancer.
c.	Shows characteristic mucinous epithelial changes.
d.	In association with ascites.
e.	None of the above.

B.

95.	Ovarian blood supply comes principally from:

a.	Uterine artery.
b.	Ovarian artery.
c.	Long artery of Hishaelis.
d.	Internal iliac artery.
e.	Common iliac artery.

B.

96.	OC pill is contraindicated in:

a.	Ca breast.
b.	Past history of jaundice.
c.	Past history of thrombosis.
d.	All of the above.
e.	None of the above.

D.

97.	Imperforate hymen may present with:

a.	Acute retention of urine.
b.	Primary amenorrhoea.
c.	Suprapubic pain.
d.	All of the above.
e.	None of the above.

D.

98.	Treatment of choice for Bartholin cyst:

a.	Incision and drainage.
b.	Excision of gland.
c.	Marsupialisation.
d.	Antibiotics.
e.	Glycerol magnesium sulphate.

C.

99.	All are true of missed abortions except:

a.	Clotting defect sets in after missed abortion.
b.	Requires urgent evacuation of uterus.
c.	Uterus usually greater than period of amenorhroea.
d.	Pregnancy test is negative.
e.	Risk of infection is higher in missed abortions.

C.

100.	Fetal distress is characterized by:

a.	Fetal heart beat type II dips and scalp blood pH 7.15.
b.	Passage of meconium stained liquor.
c.	Fetal bradycardia or tachycardia.
d.	None of the above.
e.	All of the above.

E.

101.	Commonest post-op compliactions of LSCS in:

a.	Deep vein thrombosis.
b.	Pneumonia.
c.	Urinary tract infections.
d.	Rupture of scar.
e.	Haemorrhage.

E.

102.	The smallest diameter of fetal skull is:

a.	BPD.
b.	Bregma diameter.
c.	Occipitomental diameter.
d.	Suboccipitofrontal diameter.
e.	Subparietal diameter.

A.

103.	Iron deficiency anemia in pregnancy is characterized by all except:

a.	Microcytic hypochromic RBC.
b.	Serum folate iron is 50 ug/100ml.
c.	Hypersegmented nucleus in white blood cell.
d.	TIBC of 500 up/100ml.
e.	Increased incidence of multiple pregnancy.

C.

105.	The following radiological findings indicate fetal death except:

a.	Haloes area on fetal skull.
b.	Absence of femoral epiphysis.
c.	Spalding sign.
d.	Gas bubbles in heart vessels.
e.	Ball sign.

E.

106.	The normal sequelae of events in acute PID is:

a.	Abscess formation.
b.	Hydrosalpinx.
c.	Atrophy of ovary.
d.	Pseudocyst formation.
e.	Resolution.

107.	What is the method of choice in the termination of 16 week pregnancy?

a.	Hysterectomy.
b.	Vacuum aspiration followed by uterine curretage.
c.	Intra-amniotic prostaglandins.
d.	Buccal oxytocin.

C.

108.	In a 54 year old woman with vaginal prolapse, the treatment of choice is:

a.	Vaginal hysterectomy with pelvic floor repair.
b.	Perineal exercises.
c.	Lefort’s operation.
d.	Ring pessary.

A.

110.	Prophylactic forceps delivery should be ruled out in:

a.	Cardiac disease.
b.	Previous caesarean section.
c.	Toxaemia of pregnancy.
d.	None of the above.
e.	All of the above.

D.